GU Packet 4 Flashcards
Define AKI/ARF
Sudden loss of kidney function
What are the typical pathophysiological causes of ARF
reduced renal perfusion and acute tubular necrosis
What are the 3 major causes of AKI/ARF
Prerenal disease (renal artery)
Renal disease (kidney itself)
Postrenal disease (ureter)
How can the possible cause of AKI be identified?
medical history
What are contributing factors to AKI
HTN
Hypotension
Volume loss
CHF
Diabetes
What is key to measure renal function in AKI/ARF
GFR
What test is unreliable in AKI/ARF
Serum BUN/Cr
What may UA show in AKI/ARF
hyaline casts
How is AKI/ARF treated
correcting underlying problem
Define CKD
Progression of ongoing loss of kidney function (GFR)
CKD criteria
GFR less than 60 mL/min or presence of kidney damage for more than 3 months
How many stages of CKD
5, based on estimated GFR
1-3 are asymptomatic
4 - symptomatic
5 - ESRD
*also classified according to albuminuria status
Risk factors for CKD
DM
HTN
CVD
Causes of CKD
DM
HTN
GN
What is the gold standard for testing for CKD
Measurement of GFR
What is the treatment for CKD
aimed at slowing the progression of CKD and treating reversible causes of acute deterioration; ACE inhibitors and angiotensin receptor blockers
What is the BEST treatment for CKD
Prevention
What causes 80% of ESRD
DM, HTN or both
What is the criteria for ESRD
GFR less than 15 mL/min
Describe kidney function in ESRD
no longer adequate for long-term survival without kidney transplant or dialysis
What is the best treatment option for ESRD
kidney transplant
What is the other option for ESRD treatment
hemodialysis or peritoneal dialysis
what are stones within the bladder called
vesical calculi or cystoliths
What are urinary stones most commonly composed of
calcium oxalate
What are the 3 risk factors for nephro/urolithiasis
Urinary composition
dietary
non-dietary
What are the clinical features of urolithiasis
renal/ureteric colic usually associated with hematuria, urgency, frequency, N/V
How does a pt present with urolithiasis
obvious pain and inability to get comfortable
ipsilateral tenderness
What is the gold standard for identifying almost all stones
non-contrast abdominopelvic helical CT
What is the imaging of choice for urolithiasis in pregnant women
US of kidney and bladder
Intervention for stones >4mm
ureteroscopy removal
extracorporeal shock wave lithotripsy
percutaneous nephrolithotomy
what is a complication of urolithiasis
obstruction and an upper UTI is a true urological emergency
What is the acute management for urolithiasis <6mm
fluids
medical expulsion therapy w/ alpha blockers (tamsulosin)
pain management
